卵母细胞体外成熟技术在多囊卵巢综合征不育妇女中的应用

目的评价未成熟卵母细胞体外成熟(IVM)技术对多囊卵巢综合征(PCOS)不育患者的治疗效果。方法对2004年1月至2005年8月PCOS不育患者在本中心行IVM或常规体外受精-胚胎移植(IVF-ET)、卵胞浆内单精子注射(ICSI)的周期作回顾性分析。分为无药物刺激的IVM观察组共48例、68个周期,与IVF/ICSI组39例、42个周期,比较两组的获卵数、受精率、卵裂率、种植率、临床妊娠率、流产率、卵巢过度刺激综合征(OHSS)及多胎发生率。结果IVM组与IVF/ICSI组比较,IVM组未采用卵泡刺激素(FSH),IVF/ICSI组FSH用量为(25±6.2)支;受精率分别为70.7%及63.9%(P<0.01);卵裂率分别为87.9%及99.4%(P<0.01);OHSS分别为0及7.1%(P<0.05),差异均具统计学意义。两组的获卵数、种植率、妊娠率、流产率、多胎率差异均无统计学意义(P>0.05)。结论IVM技术对难治性PCOS不育患者是一种较为节约,且不发生OHSS的有效辅助生育技术。

The application of in vitro maturation in the infertile women with polycystic ovarian syndrome

Objective: To evaluate the effects of in vitro maturation(IVM) in the infertile women with polycystic ovarian syndrome.Methods: The infertile women with PCOS who underwent IVM or IVF/ICSI from January 2004 to August 2005 were studied retrospectively.68 unstimulated cycles(48 cases) underwent IVM as IVM group,42 cycles(39 cases) underwent IVF/ICSI as control group.Main outcomes including the number of oocytes retrieval,the rates of fertilization,cleavage,implantation,pregnancy,miscarriage,ovarian(hyperstimulation) syndrome(OHSS) and multiple pregnancies were assessed.Results: No FSH was administered in IVM group,and the mean number of FSH used in control group was 25±6.2 ampoules.When compared with control group,women in IVM group had a significant(increase) in fertilization rate(70.7% vs.63.9%) and decreases in cleavage rate(87.9% vs.99.4%) and ovarian hyperstimulation syndrome(0 vs.7.1%).No significant differences between IVM group and control group were found in the number of oocytes obtained,implantation rate,clinical pregnancy rate,miscarriage rate and multiple pregnancy rate.Conclusions: Our results suggest that,for infertile PCOS women who ask for the assisted conception treatment,IVM is a more economical and less OHSS complication method than conventional IVF(treatment.)